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Background: Pulpotomy is a crucial method to preserve primary teeth until natural exfoliation. This study aimed to evaluate the clinical and radiographic outcomes of pulpotomy with iRoot BP Plus in primary molars and to explore the association between hemostasis time and these outcomes., Methods: Primary molars that underwent iRoot BP Plus pulpotomy and were followed for at least 12 months were selected for this study. Clinical and radiographic data were collected, and the success rate was analyzed in relation to factors such as hemostasis time, tooth type, and arch type. The tests of significance used were the chi-square test, Fisher's exact test, or Kruskal-Wallis test. Statistical significance was set at P < 0.05., Results: A total of 183 teeth in 106 patients were included in the analysis. The follow-up period fell into a range of 1-3 years, with a mean of 1.6 years. The clinical and radiographic success rates were 96.7% and 92.9%, respectively. The earliest time to observe the radiographic failures was half a year after the treatment, and the latest time was two years after the treatment. Among all the teeth, 130 were recorded with hemostasis time before the application of iRoot BP Plus. Compared to teeth with a hemostasis time of 5 min or less, teeth with a hemostasis time exceeding 5 min showed no significant differences in clinical and radiographic success (P = 1.000 and 0.879). Additionally, neither arch nor teeth type showed a relationship with the pulpotomy success rate (P > 0.05)., Conclusions: Pulpotomy using iRoot BP Plus in primary molars achieved favorable results. The hemostasis time may not significantly impact the outcomes of pulpotomy using iRoot BP Plus in primary molars., (© 2024. The Author(s).)

Background: The aim of this retrospective study was to determine the long-term clinical and radiographic success of our previous randomized clinical trial and to compare the success of hyaluronic acid, with the widely used formocresol and ferric sulphate agents., Methods: This retrospective study is the extension of the 1-year survey of our randomized clinical trial that had compared the effectiveness of a hyaluronic acid pulpotomy over formocresol and ferric sulphate pulpotomies and included clinical and radiographic evaluations with a follow-up period of over 24 months for 44 children who applied to our clinic between May 2019 and September 2019. Long-term clinical and radiographic data were obtained from the periodic files of our department, wherein each tooth's file was examined to identify any clinical and radiographic findings. Descriptive statistics and Pearson's chi-square tests were used to evaluate the data. Statistical significance was considered as p < 0.05., Results: The clinical and radiographic success rates of the hyaluronic acid, formocresol, and ferric sulphate groups were not statistically different at > 24 months. None of the teeth in the hyaluronic acid group showed any clinical findings at > 24 months., Conclusions: Hyaluronic acid pulpotomies exhibited comparable success rates to formocresol and ferric sulphate materials spanning over 24 months examinations. Because of convenient accessibility and applicability of hyaluronic acid, it may be recommended as a promising alternative medicament for pulpotomy treatments of primary molars. However, further long-term follow-up human studies are needed to better understand the effect of hyaluronic acid on the dental pulp of human primary molars., (© 2024. The Author(s).)

This retrospective chart review study investigates the long-term clinical outcome of Biodentine® (Tricalcium silicate) as a medicament for pulpotomy in primary molars. Data in this retrospective study was collected from the dental records of all patients that had at least one primary molar receive pulpotomy treatment (CDT code: D3221) between 01 July 2012 and 01 July 2015. This data includes child's age, medical history, dental history, dental radiographs, pulpotomy procedure details and follow-up clinical notes. Kaplan-Meier Estimate was used to measure the fraction of successful pulpotomy procedures for up to 24 months. A total of 1758 pulpotomy procedures were performed on 1032 patients in our institute in the three-year period and 21.4% of them (N = 376) had follow-up dental records that qualified for the study. Eleven teeth out of 376 teeth were excluded from the statistical analysis due to loss of/broken stainless steel crowns (3.1%). Seventeen pulpotomy failures were identified out of the remaining 365 procedures. The survival probablity of using Biodentine® as a pulpotomy medicament is 96.3% for 18-month follow-up and 95.4% for 24-month follow-up. Biodentine®, a tricalcium silicate formulation, used as a pulpotomy medicament demonstrates a high clinical success rate (95.4%) over a 24-month peroid in primary molars., Competing Interests: The authors declare no conflict of interest. Gerald A. Ferretti is serving as one of the Editorial Board members of this journal. We declare that Gerald A. Ferretti had no involvement in the peer review of this article and has no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to GS., (©2024 The Author(s). Published by MRE Press.)

Objectives: We performed this network meta-analysis to determine the comparative efficacy of formocresol (FC), ferric sulfate (FS), sodium hypochlorite (NaOCl), calcium hydroxide (CH), mineral trioxide aggregate (MTA), biodentine, and laser for pulpotomy of molar teeth., Materials and Methods: An updated search was conducted in PubMed, Embase, and the Cochrane Library to identify relevant randomized controlled trials (RCTs) published before October 30, 2022, after screening previous meta-analyses. The Cochrane risk of bias assessment tool was used to appraise the methodological quality of included studies. Clinical and radiographic success rates were assessed as outcomes. Random network meta-analysis was performed by using STATA software (version 14.0) with "network" command., Results: A total of 43 RCTs were included. Network meta-analysis indicated that CH was inferior to other medicaments and techniques in all outcomes, and MTA and biodentine was better than FC, FS, and NaOCl in terms of clinical and radiographic success rates. Results of ranking probabilities suggested that MTA ranked first in all outcomes except for clinical success at both 6 months., Conclusions: Our results suggested that MTA was associated with significant improvement in both clinical and radiographic success than other pulpotomy medicaments and techniques, with the highest probability of being the optimal option., Clinical Relevance: The current network meta-analysis determined the comparative efficacy and safety of 7 common pulpotomy medicaments in molar pulpotomy, including FC, FS, NaOCl, CH, MTA, biodentine, and laser, and the pooled results revealed comparable efficacy in clinical and radiographic success rates at 6 and 12 months between FC, FS, and NaOCl in primary molars pulpotomies. However, MTA, biodentine and laser may have more advantages than other pulpotomy medicaments for clinical and radiographic success. Therefore, in clinical practice, practitioners should select MTA, biodentine, or laser as pulpotomy medicaments in molar pulpotomy., (© 2022. The Author(s).)

Objectives: To assess long-term survival of pulpotomized primary molars and factors related to the survival of the teeth., Materials and Methods: This retrospective longitudinal study was based on electronic dental health records of children who attended public health service. Eligible children were <12 years and had a pulpotomy procedure code in their dental treatment history. Data were obtained in the period between 2002 and 2016. Chi-squared test, t -test, and one-way ANOVA were used to assess for statistical differences. Kaplan-Meier analyses were performed to create survival estimates, and the log-rank test was performed to compare differences in survival distributions. A multivariate Cox regression was conducted, and hazard ratios were calculated to estimate the hazard rate for failure., Results: Of interventions, 40% were registered in children 3-6 years of age; 56% were boys. Mean estimated survival of such molars was 82 months (SEM = 0.6) and differed by dental operator's work setting and choice of restorative materials used after pulpotomy intervention. Using a stainless steel crown (SSC) to restore pulp-intervened primary molars had the strongest effect on survival (111 months with SEM = 1.8), followed by if the intervention was performed by a specialist or specializing dentist in paediatric dentistry (99 months with SEM = 2.6)., Conclusions: The estimated survival time of pulpotomized primary molars is affected by dental operator-related factors, which should be considered in management of extensively carious primary molars of paediatric patients, both at the clinical and organizational decision-making levels. An increased focus on the use of SSC is recommended to be in the learning objectives of dental education programs.

Purpose: The purpose of the present prospective randomised clinical control trial was to evaluate the long-term clinical and radiographic success rate of pulpotomies in primary molars using pure Portland cement versus formocresol. Pure Portland cement has shown a high rate of success in pulpotomy treatments, with no side effects., Methods: Healthy 3- to 11-year-old children were treated with pulpotomies on primary molars as part of their scheduled dental treatment. Pulp dressing alternated randomly between pure Portland cement and formocresol. Data were analysed at follow-up periods up to 48 months., Results: 68 (50%) teeth with pure Portland cement and 68 (50%) teeth with formocresol in 136 healthy children (59 boys and 77 girls) were followed. The overall success rate of the pulpotomies in this study was 95.6%. Pure Portland cement was successful in 100% of the cases (68 out of 68), and formocresol in 91.1% (62 out of 68). No association was found between success and type of tooth or time range from treatment to last follow-up., Conclusion: Based on this study's results, it can be concluded that there is no superiority of one material over the other and pure Portland cement can be used in primary molar pulpotomies., (© 2020. European Academy of Paediatric Dentistry.)

Background: Pulpotomy is a vital pulp therapy performed in carious pulp exposures in teeth in which the inflamed coronal pulp is removed and medicament is placed to conserve the vital root pulps. Recently, simvastatin which is a cholesterol-lowering drug has been found to be associated with the pulp regenerative potential., Aim: The aim of this parallel two-arm randomized control trial was to evaluate and compare the clinical and radiographic efficacy of diode laser (DL) and simvastatin gel (SG) in pulpotomy of carious primary molars., Methods: Hundred primary molars (in 98 children, 65 males, 33 females with age 4-8 years) requiring pulpotomy were randomized into the DL or SG group. Pulpotomy was performed as per the standardized protocol; thereafter, all teeth were restored with resin modified glass ionomer cement followed by stainless steel crowns. Follow-up evaluations were done at 3 and 12 months using clinical and radiographic criteria. Statistical analysis was done using Chi-square test at a significance level of 0.05., Results: At 12 months, out of 92 teeth available for clinical and radiographic evaluation by blinded evaluators, DL group showed clinical and radiographic success rates of 76.1% and 52.1%, while SG group showed 80.4% and 65.2% success rates, respectively. There was no statistically significant difference between the efficacy of two techniques clinically (P = 0.49) or radiographically (P = 0.30)., Conclusions: Both SG and DL had similar efficacy for primary tooth pulpotomy, clinically and radiographically after 12 months. Considering its ease of application and low-cost, SG can be recommended as a potential pulpotomy medicament in primary molars., Competing Interests: None

Aim: Aim of this randomised clinical trial was to compare the outcome of direct pulp capping (DPC) versus pulpotomy, both with MTA, for carious primary molars., Methods: Healthy, cooperative children aged 3-9 years with at least one deep carious primary molar requiring vital pulp therapy were included. Data on the primary outcome (all-cause failure) and secondary outcomes (clinical or radiographic failure) were collected blindly semi-annually for a minimum of 1 year up to 3 years and analysed with survival analysis and generalised linear regression at alpha = 5%., Results: A total of 74 children were randomly allocated on 1:1 basis to DPC (35 children; 40 teeth) or pulpotomy (39 children; 57 teeth). Survival from all-cause failure was 79.7% [95% confidence interval (CI) 69.3-86.9%] at 12 months and 66.0% (95% CI 53.4-76.0%) at 24 months which remained stable up to 36 months, with no differences between groups (P > 0.05). No significant difference was found in the survival rate of the two groups for all-cause [hazard ratio (HR) = 0.95; 95% CI 0.45-2.01; P = 0.88], clinical (HR = 0.74; 95% CI 0.0.19-2.92; P = 0.66), or radiographic failure (HR = 0.80; 95% CI 0.0.36-1.82; P = 0.60) throughout the 3-year follow-up. Regression analysis indicated that needing a second attempt for haemorrhage control was associated with higher clinical failure rate. All-case failure was significantly different for class II versus occlusal cavities and in the latter cavities pulpotomy performed better (P < 0.001)., Conclusion: The results of the current trial indicate that both DPC and pulpotomy can be reliable options for the treatment of deep carious primary molars in cooperative children, in carefully selected cases.

Objective: To assess the effect of preoperative administration of ibuprofen and acetaminophen on the efficacy of buccal infiltration for pulp therapy in mandibular primary molars. Materials and methods: A randomized controlled trial with an ID no. NCT03423329 in Clinical-Trials.gov was conducted in the outpatient clinic of Paediatric Dentistry Department at Ain Shams University. The study was designed with two test arms where either ibuprofen or acetaminophen was administered to children whereas in the control arm a multivitamin placebo was used. Children's self-reported pain responses were recorded using Wong-Baker FACES pain scale. For statistical analysis, Chi-square test or Fisher's exact test was used to compare between the three groups whereas Friedman's test was used to study changes within each group. Results: In a sample of 60 children, a significant decrease in the mean pain rating scores was detected in all groups where success rates ranged from 40% with ibuprofen to 55% and 65% with acetaminophen and placebo, respectively. However, there was no statistically significant difference between the three groups regarding severity of pain during access cavity preparation. Conclusions: Both analgesics have no clinical advantage over the placebo in increasing the efficacy of buccal infiltration during pulp therapy in mandibular primary molars.

Aim: The aim of the study was to evaluate and compare formocresol (FC) and 5% Sodium hypochlorite (NaOCl) as pulpotomy medicaments and to assess the histological features of both pulpotomy medicaments in primary teeth., Materials and Methods: In the present study, pulpotomies were performed on 60 primary molars in 55 children aged 5-8 years. The teeth were divided into two groups NaOCl and FC were placed on the canal orifices, respectively, and crowns were restored with intermediate restorative material and glass ionomer cement. The teeth were underwent a histopathological procedure and extracted after 6 months. The Histological samples were evaluated in relation to odontoblastic integrity, pulp calcification, dentin bridge formation, and presence of pulp stone., Results: No statistically significant difference was found between the two groups with respect to inflammatory response, soft-tissue organization, and dentin bridge formation (P > 0.005)., Conclusion: Based on the results of this study Sodium hypochlorite may be a suitable medicament for conducting pulpotomy in primary teeth., Competing Interests: None

Background: The objective of this clinical study was to prospectively compare the clinical and radiographic success rates of Biodentine TM pulpotomies versus formocresol pulpotomies in children vital primary molars., Methods: A randomized, split-mouth study design was used with a sample of 37 healthy children aged 4- to 8-year-old. A total of 56 pairs (112 teeth) of carious primary teeth, 1 pair per child, were selected for treatment. One tooth from each pair was randomly assigned to either the Biodentine TM pulpotomy group or the formocresol pulpotomy group. Children were followed-up at 3, 6 and 12 months for clinical evaluation and at 6 and 12 months for radiographic evaluation. Data were collected, tabulated and analyzed using Fisher exact and McNemar tests. The level of significance was set at P < 0.05., Results: At 12 months, the clinical success rates of both Biodentine TM and formocresol groups were 100%, while the radiographic success rates for Biodentine TM and formocresol groups were 100% and 98.1%, respectively. There was no statistically significant difference between both groups (P=1). The only observed radiographic failure was furcal radiolucency in the formocresol group at 12-month interval. Pulp canal obliteration was radiographically observed in 10/56 (17.9%) and 7/56 (12.5%) cases in the Biodentine TM and formocresol groups, respectively., Conclusions: Both Biodentine TM and formocresol pulpotomy techniques demonstrated favorable clinical and radiographic outcomes over a 12-month period without any significant difference., Trial Registration: Registered on NCT03779698 . Date of Registration: 18 December 2018.

Objective: The purpose of the present study was to evaluate clinically and radiographically the effectiveness of formocresol and the antibiotic paste CTZ (chloramphenicol, tetracycline and zinc oxide-eugenol) in primary teeth pulpotomies, during a 6, 12 and 24 month period., Study Design: A total of 80 pulpotomies were performed in 58 patients between three and six years of age. The patients were selected and assigned to two groups: Group I Formocresol (FC, n=40), Group II chloramphenicol-tetracycline-zinc oxide eugenol (CTZ, n=40). The teeth were restored with glass ionomer and pre-formed stainless steel crowns. The treated teeth were evaluated clinically and radiographically at 6, 12 and 24 months., Results: After 24 months of follow up a 100% and 94.3% clinical success was obtained, in the CTZ and formocresol groups respectively (x 2 = 0.450, p>0.05). The radiographic success was of 97.4% and 94.3% respectively (x 2 = 0.920, p>0.05)., Conclusion: The performance of the antibiotic paste CTZ was superior to formocresol. No statistically significant differences were observed between the treatment groups either clinically or radiographically. More randomized clinical trials should be performed before it can be indicated safely.

Aim: To evaluate the available evidence on the efficacy of ferric sulphate (FS) compared to other pulpotomy medicaments in primary molars., Methods: A comprehensive literature search was conducted through five databases (PubMed, Ovid ® , EBSCOhost, Cochrane Library and ProQuest) and only those papers which met the inclusion criteria were accepted. The quality of the studies used for systematic review was rated by two independent researchers based on Fuks and Papagiannoulis (Eur Arch Paediatr Dent 7:64-71, 2006) criteria and graded as A (38-42), B1 (32-37), B2 (25-31), C (≤ 24). Inter-examiner reliability was measured using Kappa statistics., Results: A total of 1371 studies were available, of which only two studies full-text articles were included for quality assessment with an excellent inter-researcher agreement (k = 0.9). The comprehensive search revealed that, none of the 20 studies obtained grade A. Only three studies were graded as B1, 5 studies received grade B2 and 12 studies attained grade C. Only 4 prospective randomised clinical trials reported high success rate with FS compared to other materials. Remaining 14 studies revealed low success rate with FS compared to other pulpotomy medicaments., Conclusion: There is insufficient evidence to support the application of FS as a pulpotomy medicament in primary molars in the existing English literature. Hence, properly planned randomised clinical trials with large sample size and long-term follow up are needed to support FS as an effective pulpotomy medicament compared to other traditional and new medicaments.

Aim: The present study is an attempt to compare and evaluate postoperative assessment of diode laser zinc oxide eugenol (ZOE) pulpotomy and diode laser mineral trioxide aggregate (MTA) pulpotomy procedures in children., Materials and Methods: Forty carious primary molars indicated for pulpotomy within the age group of 4-9 years were selected and divided into two groups of 20 each using simple randomization, Group 1: Diode laser MTA and Group 2: Diode laser ZOE pulpotomy. The teeth were evaluated clinically for 1 year at 3, 6, and 12 months interval and radiologically for 6 and 12 months., Results: Clinically and radiographically, 100% teeth treated with diode laser MTA and 94% treated with diode laser ZOE were considered successful after 12-month follow-up interval. No significant difference was seen between two groups., Conclusion: Despite the success rate, the cost factor of diode laser and MTA could be the limiting factor in its judicious use in pulpotomy procedure., Competing Interests: There are no conflicts of interest

Introduction: Pulpotomy is the most common treatment to preserve vitality of cariously exposed molars. Various pulpotomy medicaments used should be antimicrobial, should help in healing without damaging surrounding tissue, and should not affect eruption of permanent teeth. Thus, this study was conducted to evaluate and compare the clinical and radiographic outcomes of formocresol (FC) and sodium hypochlorite (NaOCl) in primary molars. The aim of this randomized study was to compare the clinical and radiographic success rate of FC and 5% NaOCl as a pulpotomy medicament in primary molars., Materials and Methods: Forty children aged 4 to 9 years with primary carious molar were selected and randomly assigned into two groups: FC and NaOCl. Pulpotomy procedure was then performed followed by restoration with stainless steel crowns. Clinical and radiographic evaluation was done at an interval of 3 to 6 months., Results: Clinical success rate at 3 and 6 months was 100% for both groups. Radiographic success rate for FC was 95% at 3 months and 90% at 6 months, whereas for NaOCl, it was 90% at 3 months and 85% at 6 months., Conclusion: Based on this study, result of 5% NaOCl and FC showed no significant difference in their success rate. Hence, NaOCl can be used as pulpotomy medicament; however, further clinical trials with long follow-up period are required., Clinical Significance: Sodium hypochlorite is a potential clinical substitute of FC for vital pulpotomy treatment in primary teeth because of its exceptional biological compatibility and to evade carcinogenic effect of FC.

Objective: The purpose of the present study was to evaluate the clinical and radiographic effectiveness of zinc oxide-eugenol (ZOE) as the only pulp capping agent in pulpotomies carried out on decayed primary molars after a follow-up period of 24 months., Study Design: In total, 60 pulpotomies were performed on 38 patients aged 3 to 11 years. Pulpotomy treatment consisted of the removal of the coronal pup tissue, subsequent hemostasis, irrigation with saline solution, drying and pressure with sterile cotton pellets, and placement of a thick regular ZOE base with a minimal amount of eugenol directly over the vital radicular pulp. Additionally, a histopathologic study was carried out on some of the molars treated., Results: After a 24-month follow-up, we considered 51 procedures to be successful and 9 failures using clinical and radiographic criteria; most of the failures occurred between the 12th and 18th month., Conclusions: Results suggest that the proposed pulpotomy treatment with ZOE as the only capping agent may be considered as an alternative technique in the pulp treatment of primary molars.

Objectives: Although minimally and noninvasive caries management are advocated in pediatric dentistry, extensive caries progression often requires endodontic treatment followed by crowning of the tooth. Thus, the aim of this study was to evaluate the success of esthetic preformed zirconia crowns (PZCs) compared to the standard preformed metal crowns (PMCs) after pulpotomy in primary molars retrospectively. Method and materials: Patients' digital records in a specialized pediatric clinic in Germany were analyzed to include 2- to 9-year-olds, who had received one or more PMCs or PZCs after a pulpotomy between 2016 and 2020. The main outcomes were success, minorfailure (restoration loss, wear, or fracture), or major failure (need for extraction or pulpectomy). Results: In total, 151 patients with 249 teeth (PMC, n = 149; PZC, n = 100) were included. The mean follow-up time was (19.9 months), with 90.4% of the crowns fol-lowed for at least 18 months. The majority of the crowns were considered successful (94.4%). The differences in the success rates between PMCs (96%) and PZCs (92%) did not reach the level of statistical significance (P = .182). All minor failures (1.6%) were in the PZC group and located in the maxilla. Independent of crown type, especially first primary molars were prone to failure (7.9%; second primary molars, 3.3%). Conclusion: PMCs and PZCs both show high clinical success rates as restorations of primary teeth after a pulpotomy. However, there was a tendency of greater minor or major failure in the PZC group. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of this retrospective study was to determine the long-term clinical and radiographic success of our previous randomized clinical trial and to compare the success of hyaluronic acid, with the widely used formocresol and ferric sulphate agents. Methods This retrospective study is the extension of the 1-year survey of our randomized clinical trial that had compared the effectiveness of a hyaluronic acid pulpotomy over formocresol and ferric sulphate pulpotomies and included clinical and radiographic evaluations with a follow-up period of over 24 months for 44 children who applied to our clinic between May 2019 and September 2019. Long-term clinical and radiographic data were obtained from the periodic files of our department, wherein each tooth’s file was examined to identify any clinical and radiographic findings. Descriptive statistics and Pearson’s chi-square tests were used to evaluate the data. Statistical significance was considered as p 24 months. None of the teeth in the hyaluronic acid group showed any clinical findings at > 24 months. Conclusions Hyaluronic acid pulpotomies exhibited comparable success rates to formocresol and ferric sulphate materials spanning over 24 months examinations. Because of convenient accessibility and applicability of hyaluronic acid, it may be recommended as a promising alternative medicament for pulpotomy treatments of primary molars. However, further long-term follow-up human studies are needed to better understand the effect of hyaluronic acid on the dental pulp of human primary molars.

Purpose: To determine the variation of OXIS contact areas in primary molars using digital impressions generated from an intraoral scanner (IOS). Methods: A cross-sectional study was carried out on 214 caries-free posterior quadrants of 80 children (38 males and 42 females) aged 3–6 years. Calibration of taking digital impressions with the IOS procedure was performed initially through scanning of ten quadrants of children to provide a learning environment to the examiner. The digital impressions were then exported, and the type of interproximal contact areas present between the distal surface of the primary first molar and the mesial surface of the primary second molar were identified according to the OXIS classification. The prevalence of the types of OXIS contact areas was expressed in the form of numbers and percentages. The chi-square test was applied to investigate the variability among the arches and to understand the association of OXIS contact areas across age, gender, and arches. Results: The most common contact area type observed was I-type (59.8%), followed by S-type (15.4%), X-type (12.6%), and O-type (12.2%). The I-type contact area was most frequently seen in both males (51.6%) and females (65.5%), while the S-type contact area in males (14.7%) and X-type contact area in females (8.4% each) were the least frequent with no statistical significance between genders (p > 0.05). All three age groups studied showed the highest prevalence of the I-type contact area, which increased with an increase in age (p < 0.05). The inter-arch comparison showed a significant result in terms of the X-type contact area on the right side, and O-type, X-type, and I-type contact areas on the left side, while no statistical difference was seen in the intra-arch comparison for all contact types. Conclusion: I-type contact areas were the most prevalent across the arches, age groups and genders. [ABSTRACT FROM AUTHOR]

Objectives: The complex root canal anatomy of primary teeth keeps it very tricky to attain appropriate cleansing by biomechanical instrumentation, so obtaining an obturating material with excellent antimicrobial properties is a challenge in current clinical pulpectomy practice. So, this study aimed to assess the clinical and radiographic performance of zinc oxide-ozonated olive oil as a primary root canal filling material. Materials and methods: Ninety non-vital primary molars in children ranging from 4 to 8 years were allocated into three groups in which root canals were filled with zinc oxide-ozonated olive oil, zinc oxide-olive oil, and zinc oxide-eugenol (ZOE) according to each group after pulpectomy procedure. Clinical and radiographic evaluations were done at 3-, 6-, and 12-month follow-up periods. Statistical analysis was performed for the collected data. Results: All study groups showed a significant improvement regarding clinical signs and symptoms during follow-up periods. Ozonated-olive oil group revealed a significant increase in furcation radiodensity and a decrease in periodontal ligament space at 3-, 6-, and 12-month follow-up intervals compared to other groups. Conclusion: Zinc oxide-ozonated olive oil and zinc oxide-olive oil paste had shown good clinical and radiographic success for primary teeth pulpectomy. Clinical relevance: The intricate torturous primary root canal anatomy, in addition to the child's negative behavior, interferes with the complete debridement, so the long-lasting antibacterial effect of the primary root canal filling material aids in the pulpectomy success. [ABSTRACT FROM AUTHOR]

The purpose of this randomized clinical trial was to evaluate the clinical and radiographic success of the premixed bioceramic (NeoPUTTY ) as pulpotomy medicament in primary molars in comparison to NeoMTA® 2. Methods: Seventy primary molars indicated for pulpotomy in 42 children were randomly allocated into two groups: (I) a mineral trioxide aggregate (MTA) group (NeoMTA® 2); and (2) a premixed bioceramic group (NeoPUTTY®). Clinical and radiographic examinations of the molars following pulpotomy were conducted by two independent evaluators at six and 12 months. The data were analyzed using Fisher"s exact tests. Results: At 12 months, the clinical and radiographic success for the MTA group were 100 percent (34 out of 34) and 94.1 percent (32 out of 34), respectively. For the NeoPUTTY® group, the clinical and radiographic success were 97.1 percent (34 out of 35) and 92.8 percent (32 out of 35), respectively. No significant differences were found between the two materials. Conclusions: NeoPUTTY® showed a comparable success to mineral trioxide aggregate in primary molar pulpotomies over 12 months. Further clinical trials with larger sample sizes and longer follow-up periods are recommended. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Internal root resorption after pulpotomy is a pathological phenomenon and can lead to early root resorption and subsequent loss of the tooth.Purpose: To assess the relationship between initial inflammatory coronal pulp status in decayed primary molars treated by pulpotomy and internal root resorption after one-year follow-up.Materials and Method: In this clinical in vivo and in vitro experiment, vital pulpotomies were performed on 50 primary molars from 50 patients aged 5 to 10 years. Coronal pulp was carefully removed followed by hemostasis and placement of a reinforced zinc oxide eugenol over the vital radicular pulp. Enzyme-linked immunosorbent assay (ELISA) assay was done on coronal pulp samples and the level of tumor necrosis factor-alpha (TNF- α) and interlukin-6 (IL-6) was measured. After a 12-month follow-up, periapical radiographs were taken from pulpotomized teeth. Kolmogorov-Smirnov, Chi-square, Kruskal–Wallis, and Mann-Whitney tests were implemented.Results: 11 treated teeth (22%) showed an internal root resorption as diagnosed on X-rays. No significant association was found between TNF- α, IL-6 levels, and pathological root resorption respectively (p= 0.953) and (p= 0.944). A significant association between age and pathological root resorption was observed (p= 0.031). No significant association between remaining dentin thickness and pathological root resorption was established (p= 0.346).Conclusion: There was no association between pro-inflammatory cytokines levels/ TNF- α, IL-6 and internal root resorption following pulpotomy in pediatric patients.

Objective: To evaluate and compare clinical performance and caries inhibition of Resin modified glass ionomer cement and composite restoration in primary molars Study Design: Quasi-experimental study. Place and Duration of Study: Department of Operative Dentistry, Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Feb 2019 to Jan 2020. Methodology: Eighty-three patients fulfilling the selection criteria having at least one carious mandibular primary molar on both sides were divided by split-mouth design. Resin-modified Glass ionomer restorations were done on one side and termed Group-A, and Composite Restorations were done on the other side and termed Group-B. Each restoration was clinically evaluated regarding the appearance of secondary caries at 3, 6 and 12 months after placement by the same operator who performed the treatment. Results: A total of 166 conventional restorations were placed in the 83 children having carious mandibular primary molars, at least one on each side of the arch. The assessment of restorations, performed after six months, showed an 89.2% success rate of Resin modified Glass ionomer restorations and a 66% success rate of Composite Restoration. One year of follow-up showed an 80% success rate for Resin modified Glass ionomer restorations and 60% for Composite Restoration, as regards secondary caries; statistically significant differences were found in both groups. Conclusion: The study results showed that Resin modified Glass ionomer cement used to restore primary molars affected by caries performed better clinically than composite in assessing secondary caries. [ABSTRACT FROM AUTHOR]

Aim: To evaluate and compare the clinical outcomes of Cention-N (CN) and stainless steel crowns (SSCs) as restorations for pulpotomised primary molars, and to study clinical and radiographic outcomes of pulpotomies restored with these materials. Methods: The study was conducted on 60 pulpotomised molars with occlusoproximal caries. These were randomly divided into two groups and restored with either stainless steel crowns or Cention-N. Clinical performance of restorations and clinical and radiographic success of pulpotomy was examined at 6, 9 and 12 months. Results: The mean scores for marginal integrity deteriorated significantly at 6, 9 and 12 months in both groups but in comparison were insignificant. The mean for proximal contact deteriorated significantly for the Cention-N group, whereas the mean for gingival health deteriorated remarkably for the stainless steel crown group at successive evaluations. No tooth in either group showed secondary caries or discomfort on biting, except for one tooth in Cention-N group which presented with secondary caries. The clinical success rate for pulpotomised molars was 100% for both groups until nine months, although this had reduced by the end of 12 months. Radiographically, the success rate was 79.3% for Cention-N, while it was 86.6% for stainless steel crowns at 12 months. There was no significant difference in clinical and radiographic success between either group. Conclusion: Cention-N and stainless steel crowns are comparable for marginal integrity. However, crowns maintain significantly better proximal contacts while Cention-N was notably better for gingival health of the restored tooth. Both materials do not show secondary caries and discomfort on biting and are comparable in clinical and radiographic success of pulpotomy at the end of one year. [ABSTRACT FROM AUTHOR]

Background: Pulpotomy is the most common pulp treatment of primary molars, where surgical amputation of infected coronal pulp results in preserving the vitality and function of radicular pulp. With introduction of newer materials, the emphasis has shifted towards regeneration, in this scenario; novel materials such as platelet derived growth factor (PDGF) and propolis (PS) have been considered. Materials and Methods: This was a single-blind in vivo study; ninety human primary teeth from children aged between 5 and 10 years were divided into three equal groups in whom pulpotomy procedure was performed and they were recalled after 3- and 6-month interval for histological evaluation. Observations were subjected to statistical analysis using Pearson's Chi-square test. Results: No statistically significant difference was found between the three materials with respect to inflammatory response, soft-tissue organization, and dentin bridge formation (P > 0.05). Majority of the samples in both growth factor and propolis exhibited dentin bridges at the interface of the exposed pulp, bringing or attempting to bridge the site exposed to the pulpotomy material. The ability of the material to evoke a foreign and inflammatory cell response in the pulpal tissue was not significant. The samples of both formocresol and growth factor group showed signs of pulpal necrosis which revealed the presence of a mild necrotic zone in one specimen at 3 months. One specimen from the propolis group showed mild areas of necrosis at the end of 6 months, where none of the specimens in the growth factor group showed areas of necrosis at the end of 6 months. Conclusion: The results of the present study showed a positive outcome for growth factor and propolis groups. Further clinical trials with a larger sample size and long-term review have to be conducted for the material to be used widely. [ABSTRACT FROM AUTHOR]

Background: Lately, a paradigm shift from radical to conservative approach has popularized the selective caries removal over complete excavation in deep caries. Indirect pulp therapy over pulpotomy is being preferred due to risk of questionable pulp vitality in carious exposure of pulp. Silver diamine fluoride can be a useful tool for noninvasive caries management due to its antimicrobial and remineralization properties. Aim: The study aims to evaluate the success of minimum intervention approach using silver-modified atraumatic restorative technique (SMART) as indirect pulp treatment compared to conventional vital pulp therapy in symptomless deep carious lesions of primary molars. Materials and Methods: In this comparative, prospective, double-blinded, clinical interventional study, 60 asymptomatic primary molar teeth with international caries detection and assessment system score 4–6 were selected in children aged 4–8 years and were randomly allocated into SMART and conventional groups. The success of the treatment approach was assessed using clinical and radiographic criteria at baseline, 3, 6, and 12 months interval. Results: Data were analyzed using Pearson Chi-Square test at a significance level of 0.05. Conventional group showed 100% and SMART observed 96.15% clinical success at 12 months follow up (P > 0.05). One radiographic failure due to internal resorption at 6 months in SMART and one in the conventional group at 12 months was reported though the difference was insignificant (P > 0.05). Conclusion: Removal of all infected dentin in deep carious lesions is not required for successful caries treatment and SMART can be recommended as a potential biologic approach to manage asymptomatic deep dentinal lesions, based on optimal case selection.

Purpose: To compare three condensation techniques of zinc oxide eugenol (ZOE) as a pulpal dressing material during pulpotomy in extracted primary molars. Material and Methods: Sixty primary first and second molars were embedded in individual wax casts and divided into three groups consisting of 20 teeth each. In group I, the ZOE base was condensed by an amalgam condenser, while a moist cotton pellet was used in group II. A combination of an amalgam condenser and a wet cotton pellet tested the condensation mentod in group III. The condensation quality of the three techniques was evaluated through two digital periapical radiographs taken in a lateral and anterior-posterior direction. Results: Non-parametric Kruskal-Wallis test showed that there was no significant difference between the technique and quality of ZOE compaction. However, a significant difference was observed on condensation assessment for combined three groups on lateral radiographs vs the appearance on antero-posterior radiographs with the p-value set at

Background: Lately, a paradigm shift from radical to conservative approach has popularized the selective caries removal over complete excavation in deep caries. Indirect pulp therapy over pulpotomy is being preferred due to risk of questionable pulp vitality in carious exposure of pulp. Silver diamine fluoride can be a useful tool for noninvasive caries management due to its antimicrobial and remineralization properties. Aim: The study aims to evaluate the success of minimum intervention approach using silver-modified atraumatic restorative technique (SMART) as indirect pulp treatment compared to conventional vital pulp therapy in symptomless deep carious lesions of primary molars. Materials and Methods: In this comparative, prospective, double-blinded, clinical interventional study, 60 asymptomatic primary molar teeth with international caries detection and assessment system score 4–6 were selected in children aged 4–8 years and were randomly allocated into SMART and conventional groups. The success of the treatment approach was assessed using clinical and radiographic criteria at baseline, 3, 6, and 12 months interval. Results: Data were analyzed using Pearson Chi-Square test at a significance level of 0.05. Conventional group showed 100% and SMART observed 96.15% clinical success at 12 months follow up (P > 0.05). One radiographic failure due to internal resorption at 6 months in SMART and one in the conventional group at 12 months was reported though the difference was insignificant (P > 0.05). Conclusion: Removal of all infected dentin in deep carious lesions is not required for successful caries treatment and SMART can be recommended as a potential biologic approach to manage asymptomatic deep dentinal lesions, based on optimal case selection. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Internal root resorption after pulpotomy is a pathological phenomenon and can lead to early root resorption and subsequent loss of the tooth. Purpose: To assess the relationship between initial inflammatory coronal pulp status in decayed primary molars treated by pulpotomy and internal root resorption after one-year follow-up. Materials and Method: In this clinical in vivo and in vitro experiment, vital pulpotomies were performed on 50 primary molars from 50 patients aged 5 to 10 years. Coronal pulp was carefully removed followed by hemostasis and placement of a reinforced zinc oxide eugenol over the vital radicular pulp. Enzyme-linked immunosorbent assay (ELISA) assay was done on coronal pulp samples and the level of tumor necrosis factor-alpha (TNF- α) and interlukin-6 (IL-6) was measured. After a 12-month follow-up, periapical radiographs were taken from pulpotomized teeth. Kolmogorov-Smirnov, Chi-square, Kruskal–Wallis, and Mann-Whitney tests were implemented. Results: 11 treated teeth (22%) showed an internal root resorption as diagnosed on X-rays. No significant association was found between TNF- α, IL-6 levels, and pathological root resorption respectively (p= 0.953) and (p= 0.944). A significant association between age and pathological root resorption was observed (p= 0.031). No significant association between remaining dentin thickness and pathological root resorption was established (p= 0.346). Conclusion: There was no association between pro-inflammatory cytokines levels/ TNF- α, IL-6 and internal root resorption following pulpotomy in pediatric patients. [ABSTRACT FROM AUTHOR]

Aim: To evaluate and compare the clinical outcomes of Cention-N (CN) and stainless steel crowns (SSCs) as restorations for pulpotomised primary molars, and to study clinical and radiographic outcomes of pulpotomies restored with these materials. Methods: The study was conducted on 60 pulpotomised molars with occlusoproximal caries. These were randomly divided into two groups and restored with either stainless steel crowns or Cention-N. Clinical performance of restorations and clinical and radiographic success of pulpotomy was examined at 6, 9 and 12 months. Results: The mean scores for marginal integrity deteriorated significantly at 6, 9 and 12 months in both groups but in comparison were insignificant. The mean for proximal contact deteriorated significantly for the Cention-N group, whereas the mean for gingival health deteriorated remarkably for the stainless steel crown group at successive evaluations. No tooth in either group showed secondary caries or discomfort on biting, except for one tooth in Cention-N group which presented with secondary caries. The clinical success rate for pulpotomised molars was 100% for both groups until nine months, although this had reduced by the end of 12 months. Radiographically, the success rate was 79.3% for Cention-N, while it was 86.6% for stainless steel crowns at 12 months. There was no significant difference in clinical and radiographic success between either group. Conclusion: Cention-N and stainless steel crowns are comparable for marginal integrity. However, crowns maintain significantly better proximal contacts while Cention-N was notably better for gingival health of the restored tooth. Both materials do not show secondary caries and discomfort on biting and are comparable in clinical and radiographic success of pulpotomy at the end of one year.

Background: Pulpotomy is a vital pulp therapy performed in carious pulp exposures in teeth in which the inflamed coronal pulp is removed and medicament is placed to conserve the vital root pulps. Recently, simvastatin which is a cholesterol-lowering drug has been found to be associated with the pulp regenerative potential. Aim: The aim of this parallel two-arm randomized control trial was to evaluate and compare the clinical and radiographic efficacy of diode laser (DL) and simvastatin gel (SG) in pulpotomy of carious primary molars. Methods: Hundred primary molars (in 98 children, 65 males, 33 females with age 4–8 years) requiring pulpotomy were randomized into the DL or SG group. Pulpotomy was performed as per the standardized protocol; thereafter, all teeth were restored with resin modified glass ionomer cement followed by stainless steel crowns. Follow-up evaluations were done at 3 and 12 months using clinical and radiographic criteria. Statistical analysis was done using Chi-square test at a significance level of 0.05. Results: At 12 months, out of 92 teeth available for clinical and radiographic evaluation by blinded evaluators, DL group showed clinical and radiographic success rates of 76.1% and 52.1%, while SG group showed 80.4% and 65.2% success rates, respectively. There was no statistically significant difference between the efficacy of two techniques clinically (P = 0.49) or radiographically (P = 0.30). Conclusions: Both SG and DL had similar efficacy for primary tooth pulpotomy, clinically and radiographically after 12 months. Considering its ease of application and low-cost, SG can be recommended as a potential pulpotomy medicament in primary molars.

To compare three condensation techniques of zinc oxide eugenol (ZOE) as a pulpal dressing material during pulpotomy in extracted primary molars. Sixty primary first and second molars were embedded in individual wax casts and divided into three groups consisting of 20 teeth each. In group I, the ZOE base was condensed by an amalgam condenser, while a moist cotton pellet was used in group II. A combination of an amalgam condenser and a wet cotton pellet tested the condensation mentod in group III. The condensation quality of the three techniques was evaluated through two digital periapical radiographs taken in a lateral and anterior-posterior direction. Non-parametric Kruskal-Wallis test showed that there was no significant difference between the technique and quality of ZOE compaction. However, a significant difference was observed on condensation assessment for combined three groups on lateral radiographs vs the appearance on antero-posterior radiographs with the p-value set at < 0.05. Voids appeared with all three techniques. A combination of an amalgam condenser and the wet cotton wool pellet was the least effective method of condensation. Lateral radiographs revealed much fewer spaces between the ZOE and pulpal floor in comparison to antero-posterior images. [ABSTRACT FROM AUTHOR]

Objective: To assess and compare the clinical and radiographic success rates of biodentine and formocresol for pulpotomy in human primary teeth. Method and Materials: A randomized, split-mouth, double-blind, controlled clinical trial was carried out in 37 healthy 4- to 8-year-old children with 56 pairs (112 teeth) of contralateral primary molars indicated for pulpotomy. Matched teeth in each pair were randomized to undergo either biodentine (n = 56 teeth) or formocresol (n = 56 teeth) pulpotomy. In both groups, the teeth were restored with stainless steel crowns. The teeth were evaluated clinically and radiographically at 3 and 6 months by two blinded, standardized, and calibrated examiners. The data were analyzed using chi-square and McNemar tests with a P value of < .05 considered significant. Results: At both the 3- and 6-month follow-ups, all the 37 children with 112 treated teeth were evaluated. Clinical and radiographic success was similar for biodentine (100%) and formocresol (100%), without any statistically significant difference (P = 1). Pulp canal obliteration was radiographically observed in 10/56 (17.9%) and 7/56 (12.5%) cases in the biodentine and formocresol groups, respectively. Conclusion: Both pulpotomy techniques showed favorable clinical and radiographic outcomes at 3 and 6 months posttreatment without any significant difference. Hence, biodentine has the potential to become a substitute for formocresol in primary molar pulpotomies. [ABSTRACT FROM AUTHOR]

Objective: The technique of local anesthetic administration is an important consideration in the behavior guidance of a pediatric patient. The study hypothesized that there is no difference in the pain effectiveness in the experimental subjects with the use of single tooth anesthesia and the controls with the use of conventional technique (traditional inferior alveolar nerve block [IANB]).The purpose of this study was to compare the anesthesia effectiveness of traditional IANB; IANB using a computer-controlled local anesthetic delivery system (CCLAD); and intraligamental anesthesia (ILA) using CCLAD in pulpotomy of the primary mandibular second molars. Method and Materials: Ninety-one healthy 5- to 9-year-old children underwent pulpotomy of the mandibular second molars. They were randomly assigned into Group A (traditional IANB), Group B (IANB using CCLAD), or Group C (ILA injection using CCLAD). The effectiveness of anesthesia was measured during different steps of pulpotomy using the sounds, eyes, and motor (SEM) scale. The postoperative complications were recorded after 24 hours. Results: For all five pulpotomy steps, the anesthesia effectiveness was similar among the three anesthesia techniques. Anesthesia effectiveness was not significantly different (based on SEM scores) between the three groups during clamp application, drilling of the tooth, entering the pulp, pulp extirpation, and removal of the clamp (P = .635, P=. 996, P = .630, P = .945, and P = .101, respectively). There was no significant difference in postoperative complications between the three groups. Conclusion: The IANB anesthesia using CCLAD and periodontal ligament anesthesia using CCLAD were as effective as traditional IANB in anesthetizing the primary mandibular molars during pulpotomy. [ABSTRACT FROM AUTHOR]

The long-term effect of Zinc oxide zinc sulfate (Coltosol®) dressing material on pulpotomy success and tooth survival has not yet been studied. This study compared the success rates of Zinc oxide zinc sulfate and zinc oxide eugenol as coronal dressing materials post radicular pulp amputation in primary teeth pulpotomies. This study included healthy two-to ten-year-old children who had pulpotomies on primary molars between 2012 and 2018 at the Pediatric Dentistry Clinic of the School of Dental Medicine. Data were analyzed at several follow-ups of up to 60 months. Kaplan-Meier survival curves were used to estimate survival probabilities of Zinc oxide zinc sulfate versus zinc oxide eugenol. In the 107 children included in this study, 54 teeth were filled with Zinc oxide zinc sulfate and 53 were filled with zinc oxide eugenol. Follow-up ranged from 12.2 to 73.3 months. Overall survival of Coltosol® vs. IRM filled teeth was 87.1% and 79.3%, respectively. Overall survival probabilities for Coltosol®-filled teeth at 15.5, 24 and 45 months were 95%, 89.8% and 79.7%, respectively, while for IRM they were 93.7%, 83% and 67.7%, respectively. Treatment failure rates and type of treated teeth did not differ between boys and girls (p-value = 0.77 and 0.87, respectively). Zinc oxide zinc sulfate and zinc oxide eugenol exhibited comparable high long-term success rates of up to five years (p = 0.16). [ABSTRACT FROM AUTHOR]

Purpose: This study aimed at the following: (a) To evaluate the effectiveness of direct pulp capping (DPC) in children's primary molars using a combination of three antibiotics (3Mix-MP) as direct pulp capping materials compared with Calcium Hydroxide and (b) to assess the impact of pulp exposure diameter, its location and restoration extent on the success rate of the technique. Methods: This was a randomized double-blind, parallel, two-arm controlled trial. Forty-four primary molars with deep active caries, whose removal resulted in pulp exposures, were treated with direct pulp capping and were allocated randomly into two groups: Group A, DPC with 3Mix-MP; and group B, DPC with Calcium Hydroxide (CH). All teeth were restored with composite resin restorations. The exposures were classified according to their diameter, location and number of the filling surfaces. Clinical follow-ups were performed at intervals of 3 months for 1 year, and radiographical follow-ups were done after 6–12 months. Data were assessed using Chi-squared test (χ2) at a 0.05 level of significance and binary logistic regression was performed to determine the effect of the characteristics of the carious lesion on success rates. Results: The success rate of the technique was 54.5% in group A and 77.3% in group B, but the difference was not statistically significant. The pulp exposure diameter, its location and the number of the filling surfaces did not affect the success rate significantly. Conclusion: (a) Direct pulp capping in primary teeth achieved comparable success rates with no significant difference between 3Mix-MP and Calcium hydroxide. (b) The exposure location, its diameter and the extent of the restoration had no significant impact on the success rates of direct pulp capping in primary teeth. Trial registration: ISRCTN, ISRCTN13525994. Registered 31 October 2018 – Retrospectively registered, (http:// www.isrctn.com/ISRCTN13525994). [ABSTRACT FROM AUTHOR]

Objective: The purpose of the study was to compare the pain-related behavior and the pain perception associated with three anesthetic techniques in pulpotomies of primary mandibular second molars: traditional inferior alveolar nerve block (IANB), IANB with computer-controlled local anesthetic delivery (CCLAD), and intraligamental anesthesia with CCLAD. Method and Materials: The sample comprised 91 randomly selected healthy children aged 5 to 9 years, who were scheduled for pulpotomy in the mandibular second molar. Patients were divided into three groups according to the type of anesthesia received. Group A received traditional IANB, group B received IANB with CCLAD, and group C received intraligamental anesthesia with CCLAD. Pain-related behavior and pain perception levels were assessed using the established behavior code and the Wong-Baker FACES Pain Rating Scale respectively. Results: The mean of pain-related behavior was significantly lower (P< .001) in the intraligamental anesthesia with CCLAD group than in the other two groups. The pain perception scores were significantly higher in the traditional IANB group than in the IANB with CCLAD group, and the intraligamental anesthesia with CCLAD group (P = .044 and P <.001 respectively). The mean ± SD of the pain perception of IANB was 1.39 ± 0.200, IANB with CCLAD was 0.87 ± 0.133 and ILA with CCLAD was 0.13±0.063. Conclusion: Intraligamental anaesthesia with CCLAD was clearly associated with less pain than the IANB with or without CCLAD. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate and compare the clinical and radiographic performance of a new type of mineral trioxide aggregate (MTA, NuSmile® NeoMTA®) and ferric sulfate (FS) as pulpotomy medicaments for primary molars over 12 months. Methods: Fifty participants (25 per group) were enrolled, according to specific inclusion criteria. Each participant received a single primary molar pulpotomy either with MTA or FS, depending on random digit table method allocation. Fifteen pediatric dental residents completed all pulpotomies, supervised by specialist faculty. Two calibrated examiners performed outcome assessments according to standardized criteria. Every six months, the study teeth were evaluated clinically and every 12 months radiographically. The inter- and intraexaminer reliability was assessed using Cohen's kappa, and the chi-square test was used for statistical analysis. Results: At six months, 42 participants (21 in each group) returned for evaluation. The FS group showed 95.2 percent clinical success compared to 100 percent for the MTA group. At the 12-month clinical and radiographic evaluation, the return sample consisted of 29 participants (14 in the MTA group, 15 in the FS group). FS had 86.6 percent clinical success and 60 percent radiographic success, while MTA showed 100 percent clinical and radiographic success. At 12 months, MTA showed a statistically significantly higher success rate compared to FS (P=0.008). Examiner reliability was excellent with a kappa score greater than 0.88. Conclusion: At 12 months, MTA showed superior success as a pulpotomy medicament in primary molars compared to FS. [ABSTRACT FROM AUTHOR]

Abstract Background The objective of this clinical study was to prospectively compare the clinical and radiographic success rates of BiodentineTM pulpotomies versus formocresol pulpotomies in children vital primary molars. Methods A randomized, split–mouth study design was used with a sample of 37 healthy children aged 4– to 8–year–old. A total of 56 pairs (112 teeth) of carious primary teeth, 1 pair per child, were selected for treatment. One tooth from each pair was randomly assigned to either the BiodentineTM pulpotomy group or the formocresol pulpotomy group. Children were followed–up at 3, 6 and 12 months for clinical evaluation and at 6 and 12 months for radiographic evaluation. Data were collected, tabulated and analyzed using Fisher exact and McNemar tests. The level of significance was set at P < 0.05. Results At 12 months, the clinical success rates of both BiodentineTM and formocresol groups were 100%, while the radiographic success rates for BiodentineTM and formocresol groups were 100% and 98.1%, respectively. There was no statistically significant difference between both groups (P=1). The only observed radiographic failure was furcal radiolucency in the formocresol group at 12–month interval. Pulp canal obliteration was radiographically observed in 10/56 (17.9%) and 7/56 (12.5%) cases in the BiodentineTM and formocresol groups, respectively. Conclusions Both BiodentineTM and formocresol pulpotomy techniques demonstrated favorable clinical and radiographic outcomes over a 12-month period without any significant difference. Trial registration Registered on NCT03779698. Date of Registration: 18 December 2018.

Aim: The present study is an attempt to compare and evaluate postoperative assessment of diode laser zinc oxide eugenol (ZOE) pulpotomy and diode laser mineral trioxide aggregate (MTA) pulpotomy procedures in children. Materials and Methods: Forty carious primary molars indicated for pulpotomy within the age group of 4–9 years were selected and divided into two groups of 20 each using simple randomization, Group 1: Diode laser MTA and Group 2: Diode laser ZOE pulpotomy. The teeth were evaluated clinically for 1 year at 3, 6, and 12 months interval and radiologically for 6 and 12 months. Results: Clinically and radiographically, 100% teeth treated with diode laser MTA and 94% treated with diode laser ZOE were considered successful after 12-month follow-up interval. No significant difference was seen between two groups. Conclusion: Despite the success rate, the cost factor of diode laser and MTA could be the limiting factor in its judicious use in pulpotomy procedure.

Introduction. Apitherapy is the medicinal and therapeutic use of all the products of the hive, honey, pollen, propolis, royal jelly, wax and bee venom. The treatments cover several medical and dental areas. In the medical area it acts on the immune, circulatory, nervous, digestive and osteoarticular systems as well as, it intervenes in eye and skin treatments; meanwhile, in dentistry it participates in the surgical, endodontic, periodontal and restorative areas, providing important benefits such as bactericidal, bacteriostatic, healing, biostimulant, antioxidant, analgesic, inmunostimulating, anti-inflammatory and coagulant. Due to these characteristics, apitherapy is represented within the area of the endodontics by the use of propolis, which is a resinous, balsamic substance, and for these properties mentioned, it becomes a viable medicinal alternative for performing pulpotomies, competing with the most used, especially with formocresol. Objective. To demonstrate the effectiveness of propolis tincture applied to primary molars with indication for pulpotomy, performing a symptomatological and radiographic control at 7 and 15 days after treatment. Material and methods. The methodology used in terms of level was a descriptive investigation, of an experimental design, since a group of patients with specific characteristics to the effects of propolis was subjected to know their direct response and their evolution. Conclusions. It is shown that the 10% propolis tincture was an effective medicine for performing pulpotomies because it acts as an anti-inflammatory, resulting in a total decrease in the inflammation of the soft tissues, and a significant decrease in the inflammation presented in the periodontal ligament. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the adhesion of Streptococcus mutans to preformed zirconia and stainless steel crowns and compare plaque accumulation and gingival inflammation over a period of 1 year. Materials and methods: Thirty children between 6 to 9 years with pulpectomised bilateral mandibular primary second molars were randomly divided into zirconia/stainless steel groups. Plaque was collected from the crowns using swabs at 3, 6, 9, and 12 months. Gingival and plaque index were recorded at all follow-ups. S. mutans was cultured on tryptone-yeast-cysteine-sucrose-bacitracin agar, and organisms were expressed as colony-forming units. Within-group analysis was performed using repeated measures ANOVA and between-groups using the independent T test. Results: S. mutans were found in significantly higher numbers on the stainless steel crowns as compared with zirconia crowns at all the follow-ups. Gingival inflammation and plaque index scores were also significantly higher around the stainless steel crowns as compared with zirconia at the end of 12 months follow-up. Conclusion: Adhesion of S. mutans to stainless steel crowns was significantly greater when compared with zirconia, and minimal gingival inflammation and plaque accumulation was found in the tooth restored with zirconia crowns as compared with stainless steel crowns. Clinical relevance: Preformed zirconia crowns prevents adhesion of S. mutans onto its surface, and reduces plaque accumulation around the crown, inflammation of surrounding gingiva compared to conventional stainless-steel crowns. Pediatric zirconia crowns could help in reducing the overall microbial density and prevalence in the oral cavity, thus reducing the caries risk in the long term. [ABSTRACT FROM AUTHOR]

Introduction: Stainless steel crowns are the most successful restoration for multisurface carious lesions in primary molars. The esthetics has been poorly accepted which led to the introduction of zirconia crowns. Objectives: The aim of the study was to evaluate and compare the clinical success, parental satisfaction, and child satisfaction of stainless steel and zirconia crowns in primary molars. Methods: Thirty healthy patients aged 6–8 years bilateral pulp therapy treated primary molars were randomly divided into two equal groups of stainless steel and zirconia crowns. Tooth preparation was done according to the manufacturers' recommendations depending upon the crown each patient would receive. All crowns were cemented with Type I GIC luting cement. Patients were evaluated at 6 months, 12 months, 18 months, 24 months, and 36 months. Results: Clinical success for stainless steel crowns and zirconia crowns were similar with no statistical difference between them. Zirconia accumulated less plaque than stainless steel crowns (P = 0.047). The parental satisfaction was high with both crowns. A highly significant statistical difference existed between the 2 groups in relation to the acceptance of color (P < 0.001) and child's satisfaction (P < 0.001). Conclusion: Zirconia can be considered as an esthetic alternative in the future. [ABSTRACT FROM AUTHOR]

Purpose: Tricolcium silicate (Biodentine), a new synthetic in organic restorative cement, has shown a high rate of success in pulpotomy treatments, with few side effects. The purpose of the present randomized clinical control trial was to evaluate the long-term success of pulpotomies in human primary molars using tricalcium silicate versus formocresol. Methods: Healthy two-to 10-year-olds were treated with pulpotomies on primary molars as part of their scheduled regular dental treatment. Pulp dressing alternated randomly between tricalcium silicate and formocresol. Data were analyzed at follow-upperiods up to 48 months. Results: Thirty-seven (51.4 percent) teeth with tricalcium silicate and 35(48.6 percent) teeth with formocresol in 58 healthy children (31 boys and 27 girls) were studied. The overall success rate of the pulpotomies in this study was 94.4 percent. Tricalcium silicate was successful in 973 percent (36 out of 37) of the cases, and formocresol in 91.4 percent (32 out of 35). No association was found between success and type of tooth or time range from treatment to last follow-up. Conclusion: Tricalcium silicate shows a higher (though not statistically significant) success rate than formocresol in human primary molars pulpotomies followed for two to four years. [ABSTRACT FROM AUTHOR]

The aim of the present case report is to demonstrate a new technique for the treatment of primary teeth with coronally exposed pulps. The procedure of pulpotomy in pediatric dentistry with the use of a CO2 laser will be explained in the following article. [ABSTRACT FROM AUTHOR]

Purpose: The successful treatment of root pulp stumps in vital primary molars after pulpotomy continues to be elusive. This prospective study was aimed at evaluating the effect of the carbon dioxide laser on vital primary pulp tissue. Materials and Methods: 212 primary molars with deep carious lesions were selected for the study. All of the children were treated under general anesthesia by the same dentist. After pulpotomy, the hemostatic treatment of root pulp stumps was performed with a superpulsed CO2 laser (Nova Pulse, wavelength 10.6 μm,) with a 0.8 mm ceramic tip for 2 to 5 s. A laser power output of 3 W was used to irradiate the pulp. The laser treatment was followed by placement of a zinc-oxide/eugenol and Harvard cement base and a stainless steel crown. Clinical and radiographic data were collected 18 months after placement. Results: The overall clinical success rate was 98.1%. Overall radiographic success was 91.8%. The most frequently observed pulpal responses were interradicular bone destruction (4.27%) followed by internal resorption (2.52%) and uneven root resorption (1.68%). In 1.8%, a fistula appeared after 6 to 12 months. None of the children showed any symptoms of pain or tenderness upon percussion. Conclusion: The results show that the use of a superpulsed carbon dioxide laser with a power output of 3 W appears to be a favorable alternative for the hemostatic treatment of root pulp stumps of primary molars after pulpotomy. [ABSTRACT FROM AUTHOR]

The long-term effect of Zinc oxide zinc sulfate (Coltosol®) dressing material on pulpotomy success and tooth survival has not yet been studied. This study compared the success rates of Zinc oxide zinc sulfate and zinc oxide eugenol as coronal dressing materials post radicular pulp amputation in primary teeth pulpotomies. This study included healthy two- to ten-year-old children who had pulpotomies on primary molars between 2012 and 2018 at the Pediatric Dentistry Clinic of the School of Dental Medicine. Data were analyzed at several follow-ups of up to 60 months. Kaplan-Meier survival curves were used to estimate survival probabilities of Zinc oxide zinc sulfate versus zinc oxide eugenol. In the 107 children included in this study, 54 teeth were filled with Zinc oxide zinc sulfate and 53 were filled with zinc oxide eugenol. Follow-up ranged from 12.2 to 73.3 months. Overall survival of Coltosol® vs. IRM filled teeth was 87.1% and 79.3%, respectively. Overall survival probabilities for Coltosol®-filled teeth at 15.5, 24 and 45 months were 95%, 89.8% and 79.7%, respectively, while for IRM they were 93.7%, 83% and 67.7%, respectively. Treatment failure rates and type of treated teeth did not differ between boys and girls (p-value = 0.77 and 0.87, respectively). Zinc oxide zinc sulfate and zinc oxide eugenol exhibited comparable high long-term success rates of up to five years (p = 0.16).

Purpose: To compare the efficacy of Mineral Trioxide Aggregate (MTA) and Modified Portland Cement (MPC) as pulpotomy medicaments in primary molars. Methods: A sample of 54 children 4 to 6 years old of age, who had at least one primary mandibular second molar that needed pulpotomy were randomly placed in MTA (n = 28) or MPC (n = 26) groups. After completing the pulpotomy procedures, the teeth received a stainless-steel crown. Clinical and radiographic successes/failures were blindly evaluated at 6 and 12 months, and Fisher's exact test was used to analyze the differences. Results: At 6- and 12-month follow-ups, MTA and MPC had 100% clinical success rate. Radiographic success rates of MTA were 92.9% at 6 months and 89.3% at 12 months. While the rate for MPC group was 88.5% at both intervals. There was no statistically significant difference between the two groups. Conclusion: The results of this investigation showed that treatment success rate with MPC was comparable to MTA pulpotomy. However, additional clinical research that considers long-term follow-ups is required to test the usefulness of MPC in the pulpotomy treatment of primary teeth.